Healthcare Provider Details
I. General information
NPI: 1518300813
Provider Name (Legal Business Name): GEORGE K DONAVOS CRNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/17/2013
Last Update Date: 10/24/2024
Certification Date: 10/22/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2319 S GEORGE ST
YORK PA
17403-5009
US
IV. Provider business mailing address
601 MEMORY LANE
YORK PA
17402
US
V. Phone/Fax
- Phone: 717-812-4090
- Fax: 717-741-3554
- Phone: 717-851-1405
- Fax: 717-851-6969
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | SP014911 |
| License Number State | PA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LG0600X |
| Taxonomy | Gerontology Nurse Practitioner |
| License Number | SP013399 |
| License Number State | PA |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 364SF0001X |
| Taxonomy | Family Health Clinical Nurse Specialist |
| License Number | SP014911 |
| License Number State | PA |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | SP014911 |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: